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采用二氧化碳激光治疗口腔及口咽表皮样癌。

Treatment of oral and oropharyngeal epidermoid carcinomas by means of CO2 laser.

作者信息

Villarreal Renedo Pedro M, Monje Gil Florencio, Junquera Gutiérrez Luis M, De Vicente Rodríguez Juan C, Morillo Sánchez Antonio J

机构信息

Servicio de Cirugia Oral y Maxilofacial, Hospital de Cabueñes, Cabueñes, Gijon. Spain.

出版信息

Med Oral. 2004 Mar-Apr;9(2):172-5, 168-72.

Abstract

INTRODUCTION

The effect of the wide long-wave CO2 laser is the thermal vaporization of the tissues, getting a maximum energy concentration with a minimum of tissue penetration. In oral surgery, it is generally used for the treatment of oral and oropharyngeal small mucous tumors, due to the scarce morbidity that takes place and the absence of reconstructive necessity.

OBJECTIVE

To analyze the postoperative evolution, in the patients treated by oral and oropharyngeal epidermoid carcinomas, after CO2 laser resection. To compare it with that of the patients treated by means of conventional surgical methods, achieving the reconstruction through direct suture or the employment of local, regional or distance flaps.

METHODS

A prospective study was designed including 70 patients treated by oral and oropharyngeal epidermoid carcinomas. Thirty-five patients were treated by means of CO2 laser, in 10 cases direct wound-closure was realized, and in the remaining 25 patients some local, regional or distance flap were used. There were analysed the presence of postoperative pain, the degree of cicatricial retraction, and the speech and swallowing functional results.

RESULTS

We obtained a smaller painful degree and postoperative cicatricial retraction by the employment of CO2 laser. It permits minimizing the functional speech sequels (better words articulation) and swallowing (effective and precocious functional recovery).

CONCLUSION

CO2 laser resection has become the elective treatment for small oral and oropharyngeal epidermoid carcinomas. The reasons are the absence of reconstructive surgery necessity, the scarce cicatricial retraction, and the excellent postoperative evolution.

摘要

引言

宽波长二氧化碳激光的作用是使组织发生热汽化,在组织穿透最小的情况下实现最大能量集中。在口腔外科手术中,由于发病率较低且无需重建,它通常用于治疗口腔和口咽小黏液瘤。

目的

分析口腔和口咽表皮样癌患者接受二氧化碳激光切除术后的术后演变情况。将其与采用传统手术方法治疗的患者进行比较,后者通过直接缝合或使用局部、区域或远处皮瓣进行重建。

方法

设计一项前瞻性研究,纳入70例口腔和口咽表皮样癌患者。35例患者接受二氧化碳激光治疗,其中10例实现直接伤口闭合,其余25例使用了一些局部、区域或远处皮瓣。分析术后疼痛情况、瘢痕挛缩程度以及言语和吞咽功能结果。

结果

使用二氧化碳激光可减轻疼痛程度和术后瘢痕挛缩。它能够将言语功能后遗症(更好的言语清晰度)和吞咽功能后遗症(有效且早熟的功能恢复)降至最低。

结论

二氧化碳激光切除已成为小型口腔和口咽表皮样癌的首选治疗方法。原因在于无需进行重建手术、瘢痕挛缩较少以及术后演变良好。

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